Uterine Transcriptome: Understanding Physiology and Disease Processes

SIMPLE SUMMARY: RNA sequencing of the human endometrium and myometrium during normal menstruation and in gynecological disorders including endometriosis, adenomyosis, fibroids, and recurrent pregnancy loss has proved instrumental in advancing our understanding of the cellular complexity and dynamics that underlie these processes. Through the use of single-cell RNA sequencing, the field has uncovered multiple novel endometrial cell subpopulations that include immune cells, epithelial cells, and stem/progenitor cells that work in synchrony to coordinate the menstrual cycle and blastocyst implantation, and whose aberrant activity likely helps explain the aforementioned pathological states, which may aid in development of novel therapeutic interventions. In this review, we summarize recent advances in RNA biology pertaining to understanding the uterus through its transcriptome. ABSTRACT: In recent years, transcriptomics has enabled us to gain a deeper understanding of fundamental reproductive physiology, including the menstrual cycle, through a more precise molecular analysis. The endometrial mRNA transcript levels fluctuate during the normal menstrual cycle, indicating changes in the relative recruitment and abundance of inflammatory cells, as well as changes in the receptivity and remodeling of the endometrium. In addition to providing a more comprehensive understanding of the molecular underpinnings of pathological gynecological conditions such as endometriosis, leiomyomas, and adenomyosis through RNA sequencing, this has allowed researchers to create transcriptome profiles during both normal menstrual cycles and pathological gynecological conditions. Such insights could potentially lead to more targeted and personalized therapies for benign gynecological conditions. Here, we provide an overview of recent advances in transcriptome analysis of normal and pathological endometrium.